老年肺癌患者肺段切除术后恐惧疾病进展现状调查及影响因素分析

目的：调查老年肺癌患者肺段切除术后恐惧疾病进展现状,分析其影响因素。方法：选取2017年12月1日～2020年12月31日87例老年肺癌行肺段切除术患者,通过问卷调查了解患者的一般资料、恐惧疾病进展、症状困扰、家庭支持等情况,分析患者恐惧疾病进展的影响因素。结果：本组患者恐惧疾病进展简化量表(FoPQ-SF)总分为(35.69±6.56)分,其中45例患者FoPQ-SF得分≥34分,占51.72%;安德森症状评估量表(MDASI)评分为(123.52±11.25)分;家庭亲密度与适应性量表(FACESⅡ)评分为(89.52±8.25)分;老年肺癌患者肺段切除术后恐惧疾病进展的独立危险因素包括受教育程度、婚姻状况、疾病分期、症状困扰、家庭支持(OR=2.773、3.490、12.428、14.013、8.415,P<0.05)。结论：老年肺癌患者肺段切除术后恐惧疾病进展受多种因素影响,尤其应多关注受教育程度低、离异/丧偶、肿瘤分化程度高的患者,实施针对性干预措施,降低患者疾病进展的恐惧水平,提高临床疗效。     

肺癌化疗病人症状困扰的相关性研究

[目的]探讨肺癌化疗病人症状困扰与自我护理能力和生活质量的关系及其相关影响因素。[方法]选取2016年10月—2018年6月收治的112例肺癌化疗病人,应用Anderson症状调查量表(MDASI)、自我护理能力量表及癌症病人生命质量测定量表(FACT-C)对病人进行调查,采用Pearson单因素分析肺癌化疗病人症状困扰与自我护理能力及生活质量的关系,采用多元回归分析影响肺癌化疗病人症状困扰的相关因素。[结果]112例肺癌化疗病人MDASI症状困扰总评分为(148.64±5.36)分,自我护理能力总评分为(98.12±6.36)分,生活质量评分为(72.24±4.58)分。经Pearson单因素分析显示:肺癌病人症状困扰与病人自我护理能力及生活质量呈负相关(P0.05)。经多元回归分析可知,毒副反应程度、临床分期及自我护理能力是影响肺癌化疗病人症状困扰的主要影响因素。[结论]肺癌化疗病人症状困扰程度较重,且症状困扰程度影响病人生活质量,积极提高病人自我护理能力将有助于减轻症状困扰程度,提高病人生活质量。     

云南宣威肺癌患者化疗期间症状群和生活质量调查

目的:探讨云南省宣威市肺癌患者化疗期间的症状群与生活质量。方法:选择该院2019年1月至2019年5月接诊的60例肺癌化疗患者进行研究,采用安德森症状评估表、生存质量评估简表对所有患者进行调查,通过因子分析提取肺癌患者化疗期间的症状群,并分析症状群对患者生活质量的影响。结果:60例肺癌患者化疗期间大多会经历四大症状群:①躯体症状群;②消化道症状群;③情绪症状群;④肺癌特异性症状群。累计方差贡献率为72.83%,疲乏的发生率高达95%,且严重度高达(6.02±1.20)分,位居所有症状的首位。4种症状群与患者生活质量均呈负相关,且相关性具有统计学意义(P<0.05)。结论:云南省宣威市肺癌化疗患者经历多种症状困扰,症状之间相互协同形成4个症状群,严重影响了患者的生活质量。临床医护人员需及时准确评估患者症状困扰,形成有效干预管理措施,以提高患者生活质量。     

妇科恶性肿瘤病人化疗期间症状体验和生活质量研究

[目的]了解妇科恶性肿瘤病人化疗期间的症状体验特点对其生活质量的影响.[方法]采用问卷调查法,用急性脑卒中病人的活动性评估量表(MSAS)调查妇科恶性肿瘤病人化疗期间的症状体验特点,癌症治疗功能评价量表调查其生活质量.[结果]研究对象心理症状得分1.52分±0.95分,生理症状得分1.71分±0.76分,总困扰指数得分1.77分±0.88分,MSAS总分1.32分±0.60分.研究对象的症状各分量表得分和生活质量总分及各维度得分均呈负相关,且差异均有统计学意义(P＜0.01).[结论]妇科恶性肿瘤病人化疗期间经历许多症状,病人的症状体验影响其生活质量,症状体验和其生活质量呈负相关.     

中晚期肺癌患者症状和困扰发生的潜在类别分析

目的 探讨中晚期肺癌患者症状体验的潜在类别及相关特征，为实施精准化症状管理干预提供参考。方法 2021年9月至2022年1月，采用便利抽样法选取广州市某三级甲等医院住院治疗的中晚期肺癌患者220例为调查对象。采用一般资料调查表和汉化修订版安德森症状评估量表-肺癌模块对其调查，采用潜在类别分析对中晚期肺癌患者症状体验进行分类，并分析社会人口学资料和疾病资料对症状体验潜在类别的影响。结果 220例中晚期肺癌患者中，症状报告数量为13(7,19)个，症状严重程度得分为1.36(0.64,2.51)分。其症状体验可分为症状低发-困扰低发组(24.6%)、症状中发-困扰中发组(45.0%)、症状高发-困扰高发组(30.4%)。不同类别患者在症状报告数量、症状严重程度和症状困扰程度方面差异均有统计学意义(均P<0.05)。性别、吸烟情况、有无表皮生长因子受体突变和是否接受免疫治疗是中晚期肺癌患者症状体验潜在类别的影响因素(均P<0.05)。结论 中晚期肺癌患者的症状体验存在群体异质性，医护人员应重点关注女性、有吸烟史、有表皮生长因子受体突变、接受免疫治疗患者的症状体验评估和干预。     

妇科恶性肿瘤化疗患者症状体验与自我管理效能感的相关性分析

目的分析妇科恶性肿瘤化疗患者症状体验与自我管理效能感的相关性。方法选取我院2017年1月至2018年9月收治的96例妇科恶性肿瘤化疗患者为研究对象,分别采用记忆症状评估量表(MSAS)、中文版癌症自我管理效能感量表(SUPPH)调查患者化疗期间的症状体验、自我管理效能感水平,再利用Pearson相关性分析探索两者之间的相关性。结果患者症状体验中心理症状困扰(1. 64±0. 57)分,生理症状困扰(1. 75±0. 79)分,总困扰指数(1. 99±0. 64)分,MSAS总分(1. 85±0. 73)分,其中总困扰指数得分最高,心理症状困扰得分最低;患者自我管理效能感中自我减压(33. 16±7. 53)分、自我决策(11. 62±4. 15)分、正性态度(58. 47±13. 01)分、SUPPH总分(89. 24±28. 17)分,其中量表总分最高,自我决策得分最低。Pearson相关性分析显示,患者症状体验与自我管理效能感呈负相关(P 0. 05)。结论妇科恶性肿瘤化疗患者的症状体验越明显表明自我管理效能感越差,因此,临床护理过程中在重视疾病护理的同时应着重提升患者自我管理效能感水平,改善其生活质量。     

肺癌化疗患者生活质量的影响因素调查

目的探讨人口学因素、疾病因素(病理分型、疾病分期)对肺癌患者在化疗期间生活质量的影响。方法采用问卷调查法对100例肺癌患者进行调查,分析人口学因素与疾病因素对肺癌患者生活质量的影响。结果年龄、性别和疾病分期对化疗中和化疗后肺癌患者的生活质量总分和生理指标有显著影响(P<0.01或P<0.05);文化程度对化疗后肺癌患者的社会指标有显著影响(P<0.05);年龄、性别对化疗前、化疗中、化疗后肺癌患者的其他指标有显著影响(P均<0.01)。结论人口学因素和疾病因素可影响肺癌患者的生活质量,临床护理工作中需加以重视。     

同伴支持康复训练对肺癌患者化疗期间症状负担和心理弹性的影响

目的探讨同伴支持康复训练对肺癌患者化疗期间症状负担和心理弹性的干预效果, 为减轻患者化疗期间症状困扰提供参考。方法将南京医科大学附属南京医院(南京市第一医院)呼吸内科住院接受化疗的90例肺癌患者按照入组时间分组, 2018年1—11月入组的患者为对照组, 2019年1—11月入组的患者为试验组, 每组45例。对照组给予常规化疗护理和康复训练, 试验组在对照组基础上实施同伴支持康复训练。入院、出院时采用中文版安德森症状评估量表(MDASI-C)、心理弹性量表(CD-RISC)评价2组患者的症状负担和心理弹性。结果 2组入院时MDASI-C、CD-RISC评分比较差异无统计学意义(P >0.05);出院时, 试验组MDASI-C中症状困扰得分和症状对生活的影响得分分别为(6.19 ± 1.72)、(5.72 ± 1.45)分, 低于对照组的(7.23 ± 2.02)、 (6.75 ± 1.67)分, 试验组CD-RISC中坚韧、自强、乐观维度得分及总分分别为(28.12 ± 4.33)、 (20.88 ± 5.64)、(10.69 ± 3.00)、(59.69 ± 8.25)分, 高...     

肺癌患者化疗期间的症状群及其对日常生活的影响

目的调查肺癌患者化疗期间的症状群及其对患者日常生活的影响。方法采用中文版安德森症状评估表对183例化疗期间的肺癌患者进行调查,通过因子分析提取肺癌患者化疗期间的症状群,通过回归分析探讨症状群对患者日常活动的影响。结果肺癌患者化疗期间存在胃肠道症状群、情绪症状群、疲乏相关症状群。三大症状群对患者日常活动的困扰有显著影响(P<0.01),可解释总变异的76.2%。结论肺癌患者症状发生频率高、程度重,存在多个症状群,并且严重影响日常活动。护士应该准确及时地进行症状评估,积极对症状群进行管理与控制,以改善患者的生活质量。     

肺癌患者化学治疗的心理状态与相关因素的调查

目的探讨肺癌患者化学治疗(化疗)的心理状态及相关因素,为临床护理工作提供方向和依据。方法采用焦虑自评量表(SAS)对94例肺癌患者化疗期间的心理状态及影响因素进行调查分析。结果肺癌患者化疗期间焦虑发生率为32.98%,SAS平均得分为(42.2±10.8)分,高于国内常模,差异有差异性(P<0.05);影响患者焦虑状况发生的主要因素为性别、性格、家属的关切和对化疗并发症的担忧。结论在肺癌患者化疗期间,应有针对性进行各项护理干预减轻患者的焦虑症状,以提高肺癌患者的生活质量。     

A new variant of glucosephosphate isomerase deficiency (GPI-Utrecht).

A new case of glucosephosphate isomerase deficiency is described in a Dutch family. The activity of the enzyme was decreased to 20-25% of the normal value. Characterization of the defect enzyme showed a pronounced thermolability. Heating of the enzyme at 45 degrees C showed a loss of activity of 90% after one hour. The pH-optimum and the electrophoretic migration were normal. The Km-value for F-6-P, the Ki for the competitive inhibitors 2,3-DPG and 6-PG were in the normal range. The variant described here differs from all known variants. Therefore we propose to give to this new variant the name of GPI-Utrecht.     

Simultaneous estimation of urinary steroids by semi-automated gas chromatography. Investigation of neo-natal infants and children with abnormal steroid synthesis.

Development of a method for multicomponent analysis of urinary steroids on open-tubular columns is described. The urinary steroid conjugates were hydrolysed enzymatically, extracted on Amberlite XAD-2 columns, purified on columns of Sephadex LH-20, then analysed as methyloxime trimethylsilyl ethers on a gas chromatograph on which up to 24 samples may be automatically injected. All major urinary steroids from 17-oxosteroids to cortisol metabolites were analysed and these were quantified relative to internal standards, 5alpha-androstane-3alpha, 17alpha-diol and cholesteryl butyrate added to the samples prior to derivatisation. The precision of the full technique and reproducibility of repetitive automatic solid injection was found to be acceptable for the purpose of profile analysis. Examples of urinary steroid profiles in normal infants and infants with disorders of adrenal steroid production and excretion are given.     

H.E.L.P.治疗急性脑梗塞的护理

H.E.L.P.治疗急性脑梗塞有确切的疗效.本文强调了血管通路的护理、抗凝方法、血压动态监测、健康宣教在治疗过程中的重要作用.     

The effect of pre-incubation and direct procedure for the alanine transaminase assay in two kits compared.

The kinetic measurement of serum alanine transaminase was carried out on two enzyme kits (Roche and Calbiochem), done as a direct method and a pre-incubation method. Variable results from commercial control sera and patient sera by these four procedures were obtained. Pre-incubation enzyme values were generally lower than the direct values (mean difference 10%), but there were marked differences between the results from the two kits. This finding has important significance especially for laboratories participating in external QC Programmes. Frequent precision checks of the method and a local reference range are therefore necessary.     

Smoking and serum alpha 1-antitrypsin in 1296 healthy men (author's transl)]

Serum alpha 1-antitrypsin (alpha 1AT) was measured by radial immunodiffusion in 1296 healthy men aged 18--50 years. Other biological criteria, including leukocyte count and alpha 2-globulins were measured and the subjects were given a detailed questionnaire on their smoking habits. Results showed a very strong positive relationship between smoking and serum alpha 1AT: the heavy smokers had a serum alpha 1AT 20% higher than the non-smokers, and among subjects who stopped smoking, the level returned rapidly to normal. There were also close interrelationships between serum alpha 1AT, smoking, leukocyte count and a alpha 2-globulins. A discussion of these results is presented.     

A note on the practical aspects of the assay of N-acetyl-beta-glucosaminidase in human urine.

1. Some practical aspects of the assay of urinary N-acetyl-beta-glucosaminidase activity were studied in patients with renal disease. 2. Centrifugation and dialysis of urine were not necessary prior to assay. 3. When enzyme activity was related to urinary creatinine random urine samples could be used. 4. Since preservatives used to prevent bacterial growth may inhibit enzyme activities, samples should be assayed immediately after collection or stored at 4 degrees C or 20 degrees C. 5. Mild visible haemoglobinuria, eg. derived from lysed red blood cells did not interfere with the enzyme assay.     

The diagnostic value of urinary enzyme measurements in hypertension

N-Acetyl-beta-D-glucosaminidase (NAG), beta-D-galactosidase, alkaline phosphatase (ALP) and leucine aminopeptidase (LAP) were assayed in the urine of 100 normal and 112 hypertensive subjects. Age-related urinary activities for these enzymes in the normotensive control subjects are presented. A new procedure for the assay of urinary ALP using 2-methoxy-4-(2'-nitrovinyl)phenyl (MNP) phosphate is described. Thirty-five of the hypertensive patients were considered to have primary renal disease. The urinary activity of NAG was increased in 27 (77%) of these patients and the detection of primary renal disease was not enhanced by measurements of the other urinary enzymes. Testing the urine both for NAG activity and protein, led to the detection of 91% of these patients. The assay procedures described are simple to perform and can be carried out in outpatient clinics. The measurement of urinary NAG activity is a cheap and reliable method for detecting renal disease in hypertensive patients but maximum diagnostic yield is achieved when proteinuria is determined as well.     

Defective erythrocyte pyruvate kinase.

A defective pyruvate kinase (EC 2.7.1.40) is described. The abnormal PK is characterized by a shift in the R in equilibrium T equilibrium to the T-state. The Ko.5 for the substrate phosphoenol pyruvate is about 6 times higher than for the normal enzyme, while the KM value for the positive effector Fru-1, 6-P2 is increased. In agreement with a shift to the T-state is the increased affinity of the abnormal enzyme for the negative effectors ATP and alanine. The results are discussed in relation to other abnormal pyruvate kinases.     

Assessing airway inflammation: from guessing to quantitative measurements

Diagnosing asthma and following the response to treatment have relied on lung function measurements. Improved knowledge of the cellular events leading to airflow limitation has led to new clinical methods to assess the inflammatory component of the disease. Induced sputum analysis and exhaled nitric oxide (NO) measurements are already tools for clinical practice. New cell-specific inflammatory markers and further innovations in the testing of exhaled air, e.g. breath condensates and technical development of simple methods and devices, will also benefit the busy practitioner in near future. Assessing airway inflammation by quantitative measurements, instead of guessing, will also strengthen the role of anti-inflammatory medication as first-line treatment of asthma, even in its mildest forms.